Lauren works as a case management RN on Steen 2. There was a patient who came in as a high-level trauma alert after being ejected from her Jeep, 27 years old, bad brain injury among other issues. She had no health insurance and will likely need care for the rest of her life. Lauren helped to get her health insurance, find a facility to accept her into their brain injury/soma stimulation program, and fought her Aetna insurance to get authorization to send her to rehab.

It is hard to qualify all of the work it takes to achieve something like this. There are so many disappointments and issues that come up along the way. Helping family to apply for insurance, convince facilities to consider the patient, submit documentation for authorization, get docs to fight on her behalf with peer to peer reviews…Aetna at first gave the wrong type of authorization, then the rehab facility no longer wanted to take her. Then Lauren fought multiple times on long phone calls with Aetna to advocate for the patient to get the chance for rehabilitation. She was belittled by Aetna staff, given incorrect information, coordinated meetings with their administration, all for this young woman to get the chance to improve her condition with rehabilitation. Lauren also had to brace the patient's mother for the possibility that her daughter may have to live out her days in a nursing home. She communicated with many long-term care facilities and had many denials. In Lauren’s eyes, sending this young woman to LTC without rehab was a death sentence. She truly carried the weight of the patient's prognosis on her shoulders and fought daily to show Aetna and the rehab center that this young woman deserved a chance to improve her functional and cognitive status, instead of sitting in bed at a nursing home for the rest of her life.

Lauren shed many tears over this case. The trauma physicians, PAs, nurses, and nurse managers were all involved in caring for this patient and all recognize how much Lauren did to help this family. The patient's mother even wrote to news outlets and political figures to help with this case – none were able to assist. Lauren likes to try to convince us that she’s dead inside but we all know the truth – she is kind, funny, and thoughtful, brings so much fun (and décor!) to the department, she is knowledgeable and her perseverance has impacted the life of this patient and her family immeasurably.

We understand that the patient may still live out her days in a nursing home and may not have a meaningful recovery from her injuries, but due to Lauren not giving up on her, her poor mother can feel at ease knowing that everyone at Capital Health did their best for her young daughter.